Form : Great Lakes Aquarium

Name:*

First Last

Name of your group:*

Address (of outreach location)*

Street Address Address Line 2 City State ZIP Code

Email:*

Phone:*

Best Time to Reach You:

:

School or Group:*

Formal School
Homeschool
Other group (adults, scouts, clubs etc.)

What kind of experience are you seeking?*

Classroom Visit
Educational Outreach

Please describe the setting of the classroom visit or educational outreach space (i.e. traditional classroom, auditorium, soccer field)

Preferred Date of Visit:*

First Choice:	Second Choice:	Third Choice:

Preferred Time of Visit:*

First Choice:	Second Choice:	Third Choice:

Which class are you interested in?*

A complete list of class descriptions can be found here. Please keep in mind that only the classes listed below are available for outreach programming.

Date of Event:*

Time of Event (start and finish):*

What Educational Outreach are you interested in?*

Meet an Animal Ambassador
Buoyancy Booth
Plankton Station
We are open to any of the outreach options.
Not quite sure, I need more information.

Please note: Our educators will do their best to accommodate your preferences, but outreach options may depend of the event's space, time, etc.

Grade Level of Students:*

Number of Students:*

Preferred Method of Payment:

Please use the space below to share other important information about your group or proposed schedule.

Classroom Visit and Educational Outreach Request